TELEHEALTH SERVICE-LEARNING CLINICS TO MEET COMMUNITY AND PHYSICAL THERAPY STUDENT NEEDS DURING A PANDEMIC: AN EDUCATIONAL CASE REPORT

M. Danzl¹, C. Crandell¹, E. Ennis¹, T. Granada¹, D. Hall-Bibb¹, J. Hartmann¹, L. Kerr¹, P. Lonnemann¹, L. Miller¹, G. Pariser¹, E. Ulanowski¹

Background: In our Doctor of Physical Therapy (PT) program, students matriculate through “Collaborative Service Learning and Community Engagement” (8 credits, 2 years). In mentor/mentee dyads, students treat patients for 4 weeks in service-learning clinics (SLCs) under faculty mentorship. The coronavirus pandemic disrupted the course, necessitating an alternative course delivery method. Telehealth was employed in which digital communication technologies were utilized to provide PT virtually.

Purpose: The purpose is to describe the feasibility and experiences of telehealth SLCs to meet the needs of the community and students during the pandemic.

Methods: Faculty reflected upon course objectives and learning outcomes and identified virtual pedagogical activities, determining telehealth as the best means forward. Telehealth was feasible at 5 clinics, serving sports, orthopedic, geriatric, pediatric, and neurologic populations. Students and faculty participated in an inservice about telehealth best practices. Students (n=41) completed the virtual SLC experience (patient care, documentation, mock billing, Grand Rounds, mentor/mentee feedback, professional behaviors self-assessments, advising meetings) with mentorship from 17 faculty. Technology utilized was permissible due to federal waiver (Microsoft Teams, Zoom, FaceTime, phone). Data examined included student reflection papers, patient satisfaction, and course evaluations.

Results: Services were provided to 26 patients (64 visits). Anecdotal patient feedback included benefits (e.g., more specific treatments, real-time enhanced virtual biofeedback, comforts of home, interventions as effective as in-person) and challenges (e.g., learning new technology, finding optimal technology). Course evaluations indicated gratitude for the opportunity and perceived support from peers/faculty. Students cultivated communication skills through the site-specific virtual Grand Rounds, noting a more intimate and interactive experience compared to previously in-person experiences. Student reflection paper themes indicated enhanced professional development and improved readiness for upcoming clinical education. All students discussed development of a deeper understanding and personal growth across several professional core values (compassion/caring, altruism, professional duty, excellence, accountability). Students noted an increased ability to adapt to change quickly, improved confidence to provide telehealth effectively, enhanced intervention creativity, as well as improved communication and problem-solving skills.

Conclusion(s): Telehealth is a feasible means of providing continued service to community members within a service-learning curricular structure and continuing PT student education in a virtual environment. Facilitating factors include technology access and training as well as continuing education about best practices with telehealth. Patients perceived benefits from continued support and services, particularly given the restrictions to mobility opportunities during the pandemic. Students perceived an opportunity to grow professionally and cultivate skill sets pertinent for service delivery in a COVID-19 era.

Implications: PT telehealth is becoming more prevalent with parity laws emerging to ensure coverage. Though born from a pandemic, this experience provided an opportunity to enhance student learning and continue to meet objectives. Telehealth SLCs offer opportunity to students to adapt developing clinical assessment skills to a hands-off method, which can enhance observational analysis and improve communication. This skill development and growth can carry forward to full-time clinical placements and future practice. Telehealth SLCs allow continued service to patients who would have had care interrupted. As telehealth compliance rules return to normal, programs need to determine platforms that allow for appropriate student supervision.

Funding, acknowledgements: Funding was not procured for this work.

Keywords: telerehabilitation, service learning, professional development

Topic: Education: methods of teaching & learning

Did this work require ethics approval? Yes

Institution: Bellarmine Univnersity

Committee: Institutional Review Board

Ethics number: 853